平衡表演和适应：一项关于医学生早期临床实习体验的定性研究。
Balancing acting and adapting: a qualitative study of medical students' experiences of early clinical placement.
机构信息
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
出版信息
BMC Med Educ. 2022 Sep 3;22(1):659. doi: 10.1186/s12909-022-03714-y.
BACKGROUND
Clinical learning experience is an important part of medical education. In the clinical learning environment, students are exposed to various aspects of medical care and may train their skills under supervision. Supervision, in which students' learning needs and the outcomes of placements are met, is essential. The aim of this study was to explore medical students' experiences of the early stages of clinical training.
METHODS
In 2021, 18 individual semi-structured interviews were conducted with medical students after their first clinical placements in semester 5. The interviews were transcribed verbatim and analyzed using qualitative content analysis according to Graneim and Lundman.
RESULTS
The findings resulted in an overall theme: balancing acting and adapting. Three categories described that the clinical learning environment was a big leap from campus, that personal relationships influenced learning, and that the organization of clinical placements was suboptimal. The students were encouraged to push themselves forward to practice clinical skills. This, however, did not suit all the students; the cautious ones risked becoming passive spectators. The intended learning outcomes were not frequently used; rather, the supervisors asked the students what they had learned, or the students focused on what seemed to be important on the ward. The students tried to adapt to their supervisors' working situation and not to be a burden to them.
CONCLUSIONS
Our findings show that the transition from learning on campus was sometimes abrupt, as the students had to switch to a more active learning role. Ad hoc solutions in supervision occurred, which contributed to the experience that educational responsibilities were downgraded and the opportunities for clinical training varied. Rather than trying to change the circumstances, the students opted to adapt to the busy clinical learning environment.
背景
临床学习经验是医学教育的重要组成部分。在临床学习环境中，学生接触到医疗的各个方面，并在监督下进行技能训练。监督对于满足学生的学习需求和实习成果至关重要。本研究旨在探讨医学生在临床培训早期阶段的经历。
方法
2021 年，对 5 个学期后首次临床实习的 18 名医学生进行了 18 次单独的半结构化访谈。访谈逐字记录，并根据 Graneim 和 Lundman 的方法进行了定性内容分析。
结果
研究结果得出了一个总体主题：平衡行动和适应。三个类别描述了临床学习环境与校园有很大的不同，个人关系影响学习，以及临床实习安排不理想。学生被鼓励积极实践临床技能。然而，这并不适合所有学生；谨慎的学生有成为被动旁观者的风险。预期的学习成果并没有经常使用；相反，主管会询问学生他们学到了什么，或者学生关注病房中似乎重要的内容。学生试图适应主管的工作情况，以免给他们带来负担。
结论
我们的研究结果表明，从校园学习到临床学习的过渡有时很突然，学生必须转变为更积极的学习角色。监督中出现了临时解决方案，这导致教育责任降级，临床培训机会也各不相同。学生选择适应繁忙的临床学习环境，而不是试图改变环境。
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